IVF Center
And The Longing Ends
IVF Center
Overview
IVF treatment is the most commonly preferred assisted reproduction technique for the couples who cannot have children by natural means. The vast majority of the basic stages necessary for the formation of pregnancy in IVF treatment (In Vitro Fertilization), are performed outside the body in a laboratory environment, under controlled conditions.
In IVF treatment, hormone therapy is applied to obtain more than one egg from women, and maturing egg cells are harvested. Sperm and egg cells taken from the couple are brought together in a laboratory environment. The resulting embryos are transferred directly to the uterus or are frozen, to wait for the appropriate time for treatment. The fertilization, which under normal conditions occurs in the female body as a result of sexual intercourse, is thus transferred to the laboratory environment.
In IVF treatment, while the egg cells taken from the woman and the sperm cells taken from the men can combine and form the embryo without any intervention, in some cases, the best quality sperm must be injected into the egg by microinjection method for the formation of the embryo. This method, which is called intracytoplasmic sperm injection (ICSI), is often preferred for the couples with male induced infertility problems.
IVF treatment can be applied in many cases of infertility. One of the most important reasons why this treatment is preferred at such a high rates is that it can give results in cases of infertility caused by both men and women, or in the case of infertility whose cause cannot be determined.
Treatment
The Process Before IVF Treatments
If pregnancy does not occur despite regular and unprotected sexual intercourse for 1 year, couples can resort to assisted reproductive techniques. Nowadays, successful results can be obtained in selected patients with Intrauterine insemination (IUI) and IVF treatment.
In order to increase the success rate of IVF treatment and to ensure that couples receive the happy news, it is important that treatment planning is made specifically for each couple. Before IVF treatment, with a series of tests performed on both women and men, both the underlying causes of infertility can be determined and information can be obtained about whether auxiliary methods should be used in the treatment process.
What Tests Are Performed Before IVF?
Different tests are performed over women and men in order to determine the treatment protocol before starting the IVF treatment.
In addition to all these tests, for women, hysterosalpingography and additional ultrasound imaging may need to be performed. With the evaluation of the data obtained as a result of all these tests and imaging methods, IVF treatment planning can be carried out.
Reducing the pre-IVF treatment process to the test stages carried out only for men and women would be an incomplete approach. There are various factors that couples should pay attention to before IVF treatment. These factors, which can be attributed with lifestyle choices, can provide a positive effect on the treatment process.
Things to Consider Before IVF Treatment
Couples who are found to be suitable for IVF treatment as a result of physical examinations and tests performed need to make various changes in their lifestyle.
IVF treatment can become an exhausting process in which many physical and psychological restrictions may be required. A high level of awareness can result in couples being in the best mental and physical condition during the treatment process. Undoubtedly, these gains will have an impact over the treatment results.
All these measures considered apply to both women and men. The role of men and women in the formation of pregnancy is equal. Another factor requires attention is overcoming the stress brought about by the process. Yes, IVF treatment does not promise an absolute result, but it offers a very important opportunity to couples who, over the years, wanted to finally receive that happy news. In the process, couples need to understand each other and manage stress successfully.
Stages of IVF Treatment
As an sssisted reproductive technique, In Vitro Fertilization or IVF treatment consist of certain stages. As I mentioned in my previous contents, the main goal of treatment is to perform the steps that normally occur naturally in the pregnancy process, but in a controlled manner and in a laboratory environment.
Before going into details about the question "What are the stages of IVF treatment?", I will provide some details in order explain the process more clearly.
The first stage of IVF treatment is the harvesting of egg cells from the woman. Before the realization of this stage, the expectant mother is started hormone therapy in order to harvest more egg cells. Since our main goal is to create as many healthy embryos as possible, we need to trigger the ovulation process for the women.
With hormone therapy, we can ensure that more eggs are formed in the monthly cycle and harvest them when they mature. At this step, the male factor comes into play. We take semen samples from men and separate the quality sperm from it. According to the results of semen analysis, we have different options to choose from.
If there is no problem in the sperm quality of the men, we do not make an additional intervention for the merging of egg cells and sperms and we expect fertilization to occur outside the body in a controlled laboratory environment. But men's sperm don't always make this possible. In other words, we also need to intervene in the fertilization process. In this case, we need to select the highest quality sperm and inject it in the egg using a special technique.
We follow up when fertilization occurs and our embryos are formed. We identify high-quality embryos and transfer them to the uterus of women with a simple procedure and expect them to hold. Of course, all these listed steps can be customized. We may need to support the basic stages with Auxiliary Methods in IVF Treatment. The couble-specific approach is extremely important. Although the stages of IVF treatment are generally standard, it should not be forgotten that intermediate treatments may be necessary.
Stages of IVF Treatment
After all the necessary examinations have been performed as part of IVF treatment, if it is concluded that the couples is suitable for treatment, the ovaries of the woman are first over-stimulated.
- Overian Stimulation
- Oocyte Pick-Up (OPU)
- Collection of Sperms
- Fertilization
- Embryo Transfer
- 5.Day Transfers
Since it is aimed to obtain both the ideal number and ideal quality oocytes with the stimulation of the ovaries, it is important to consider variables such as the age of women, her ovarian reserves, basal FSH and E2 levels, AMH levels, body mass index values, when determining the doses of the drugs to be administered.
At the stage of ovulation induction, both the use of hormonal drugs and the follow-up of the process are required. When the stimulation of the ovaries begin, ultrasound examination is needed at regular intervals to measure the size of the egg sacs and determine the response of the eggs to drugs. If, during the check-ups, data are obtained indicating that at least three eggs have matured and the follicles have reached over 17 mm, cracking injections are administered. The purpose of cracking injections in IVF treatment is to fully mature the eggs. Cracking injections are HCG hormone injections that mimic the hormone Luteinizing that is normally secreted by the pituitary gland and allows the eggs to crack in the natural cycle. These injections can be made intramuscularly or under the skin.
The timing of the cracking injections is extremely important. The most important thing to consider is that the egg harvesting process, which is the second stage of IVF treatment, should be done before the eggs are cracked. If the cracking injectiong is performed early or the egg harvesting stage is performed late, the matured eggs cannot be used for IVF treatment. For this reason, it is recommended that the egg harvesting process be performed 34 – 36 hours after the cracking injection.
In the past years, techniques such as laparotomy and laparoscopy were used to harvest eggs. It was possible that these techniques were extremely complex and led to complications such as severe tubal disease and multiple adhesions. Today, egg harvesting is done by a highly developed and minimally invasive method.
The egg harvesting process, also called OPU, is an extremely comfortable procedure performed under sedation. It is performed via vaginal ultrasound. During the procedure, the follicles are viewed via ultrasound and with the help of a special syringe, the maturing follicles are reached from the vaginal canal and the fluid containing the oocyte is collected. Although it varies from patient to patient, usually, between 3 and 10 eggs are harvested. The duration of the procedure varies between 15 – 30 minutes depending on the number of eggs to be harvested. During egg harvesting, in order not to spoil the fluid aspirated from the maturing follicles, it is necessary to quickly send it to the embryology laboratory.
All these listed stages are valid if spermatozoa are present in the semen. However, for the men diagnosed with azoospermia, we need to resort to sperm collection techniques. The technique to be applied to get the sperm from a man varies according to the type of azoospermia. If sperm production is present in the testicles, but there is no sperm in the semen, there is azoospermia due to obstruction, and in this case, sperm can be collected from the testicles, epididymis or vas deferens.
In patients with non-obstructive azoospermia who do not have sperm production in their testicles, an advanced surgical technique called MicroTese becomes a necessity. During the MicroTESE surgery, which is performed under general anesthesia, all sections of the testicles where sperm are likely to be present are scanned and the testicular tissues that are likely to host sperm are collected. While the surgery is still going on, the embryology laboratory starts the sperm examination. The operation of patients with azoospermia, which is not due to obstruction, can be performed in a different time periods. Sperm can be frozen if the eggs have not yet been harvested, or if the eggs have been harvested before the operation, these eggs can be frozen.
If fertilization occurs, the embryos are monitored. If deemed necessary, Assisted Hatching (weakening of the embryo membrane) and preimplantation genetic testing methods can be applied.
Embryo freezing can be performed in the presence of high-quality embryos that could not be transferred. Thus, if the IVF treatment fails, the second trial can be performed with just the embryo transfer. Embryo transfer is the final stage of IVF treatment. After this stage, the embryo is expected to attach the uterus (implantation).
In order to understand whether pregnancy has occurred after the transfer, about two weeks of waiting time is required. During this process, women may need to take the progesterone. Thanks to progesterone, the probability of implantation can be increased. Hormone therapy needs to be carefully planned.
A pregnancy test can be performed 12 days after embryo transfer. After IVF treatment, the formation of pregnancy and the healthy birth of the baby may vary according to the age of the mother, the quality of the embryo, past pregnancies, the cause of infertility and mother's lifestyle.
Stages of IVF Treatment
In Vitro Fertilization is an extremely safe and assisted reproductive treatment in which serious complications rarely occur. Planning the process specifically for couples and following each stage ensures that the risks that may be experienced are reduced. Nevertheless, IVF treatment is a medical treatment and is also known to have certain risks.
- Overian Hyperstimulation Syndrome (OHSS)
- Multiple Pregnancies
- Risks Associated with the Egg Collection Process
- Ectopic Pregnancy
- Misgarriage
OHSS is not the only risk specific to the stage of ovarian stimulation. Side effects such as mild bruises at the injection site, nausea, vomiting, temporary allergic reactions, increase in vaginal discharge and fatigue may be encountered.
How To Increase the Success Rate of IVF Treatment?
The most commonly applied infertility treatment for couples who cannot have children naturally is IVF treatment. The first birth as a result of IVF treatment took place in 1978. Since then, many changes have taken place in the treatment process and a lot of progress has been made. Despite all these developments, it is not possible to talk about 100% success rate for IVF treatment. Multiple trials may be required for IVF treatment, and this requirement may become an experience that challenges couples in various ways. Therefore, evaluating the possibilities at the very beginning of the process can have a significant impact on the success rate of IVF treatment.
- Comprehensive Preparation is Necessary for the IVF Process
- Preimplantation Genetic Diagnosis Can Be Performed
- Resorting to Auxiliary Methods in IVF Treatments
- It Is Important For Couples To Make Lifestyle Changes
Any obstruction in the tubes and the accumulation of fluid in the tubes is called hydrosalpinx. In the presence of hydrosalpinx, leakage of fluid accumulated in the tube into the uterus may interfere with embryo transfer. So, if the cause of infertility is hydrosalpinx, at first, this health problem should be addressed.
If a genetic anomaly is present in one or both parents, this diagnostic method, which makes it possible to select the healthiest embryo among the embryos formed, has an important effect on increasing the success rate of IVF. PGT can also be recommended when there is no risk of genetic diseases. In recurrent IVF failures, severe male infertility, unexplained infertility, and late age of the expectant mothers, PGT can increase the success rate of IVF.
The main purpose of auxiliary methods is to increase the success rate of IVF treatment. Therefore, it is decided whether they will be applied in accordance with the couple in question. For more detailed information about Auxiliary Methods in IVF Treatment, you can access the relevant page via this link. To mention briefly, thanks to the auxiliary methods such as ICSI, which is included in the process in cases where sperm quality is low, PRP application to the ovaries to increase egg quality, and endometrial scratching to facilitate embryo transfer, solutions can be found to "couple-specific" problems that are likely to reduce the success rate of IVF treatment.
It is known that habits such as smoking and alcohol consumption, being overweight, stress, an unhealthy diet and inactivity can have a negative effect on the success rate of IVF treatment. Therefore, couples who decide to resort to infertility treatments to have a baby need to take the necessary steps to live a healthier life.
Stress after infertility diagnosis is extremely common and there are many scientific studies showing that infertility leads to stress. The controversial and generally accepted fact, although not yet certain, is that stress can be a cause of infertility. Some studies conducted in recent years have shown that for women with high levels of the alpha-amylase enzyme in their saliva, which indicates stress, it take 29% longer to conceive compared to women who have low levels of this enzyme. We also know that cortisol, known as the stress hormone, affects the signaling between the brain and the ovaries.4 Therefore, success in stress management remains an important factor in the process of IVF treatment. In order to eliminate the stress and concerns experienced specifically during the period, couples may want to receive psychological support.